Risk factors for noninvasive ventilation failure in cancer patients in the intensive care unit: A retrospective cohort study

Abstract

Noninvasive ventilation can avert ARF for most ICU cancer patients with ARF. For patients with pulmonary infections and high severity scores, NIV should be used with caution. Identifying risk factors for NIV failure using a comprehensive diagnostic approach and monitoring of NIV are paramount to improve outcomes.

What prevents critically ill patients with respiratory failure from using non‐invasive positive pressure ventilation: A mixed‐methods study

“…Those patients with higher scores of severity on measures, such as APACHE II, were more likely to convert to intubation in previous studies (Antonelli et al , ; Confalonieri et al , ; Demoule et al , ; Ferreira, Medeiros, Rego, & Caruso, ), which is consistent with the current findings.…”

“…Those patients with higher scores of severity on measures, such as APACHE II, were more likely to convert to intubation in previous studies (Antonelli et al, 2007;Confalonieri et al, 2005;Demoule et al, 2006;Ferreira, Medeiros, Rego, & Caruso, 2015), which is consistent with the current findings. Moreover, the logistic regression analysis showed that those patients for whom NPPV made breathing easier tended to avoid intubation.…”

Critical care of patients with cancer

“…More recent studies did not confirm those earlier reports of a benefit from early NIV compared with oxygen therapy . NIV failure is more frequent in patients with cancer and is accompanied by a higher rate of intubation‐associated complications and a worse prognosis, whereas early intubation is correlated with a better outcome . Infection as the cause of acute respiratory failure, high respiratory rate under NIV, a longer delay between admission and initiation of NIV, a need for vasopressors or renal replacement therapy, and acute respiratory distress syndrome were identified as independent factors associated with NIV failure .…”

“…184,185 NIV failure is more frequent in patients with cancer and is accompanied by a higher rate of intubation-associated complications and a worse prognosis, whereas early intubation is correlated with a better outcome. 9,183,[186][187][188][189][190] Infection as the cause of acute respiratory failure, high respiratory rate under NIV, a longer delay between admission and initiation of NIV, a need for vasopressors or renal replacement therapy, and acute respiratory distress syndrome were identified as independent factors associated with NIV failure. 176,183,190 In an analysis by Azoulay et al, patients who received NIV without subsequent invasive mechanical ventilation had a mortality rate of only 15%, whereas patients with late NIV failure had a mortality rate of 93% versus 78% in patients who received first-line invasive ventilation.…”

Global Critical Care: Moving Forward in Resource-Limited Settings

“…Unfortunately, these components are not always available in resource-limited settings [2,3], where the burden of disease is greater [4], outcomes are poorer [5,6], and local characteristics require context-specific approaches to the organization of critical care services.Critical care delivery, education, and research require a global perspective based on epidemiologic considerations. The burden of critical illness in resource-limited settings is not well described, but the best available estimates suggest that it may be greater than in resource-rich settings [7,8] due to deficiencies in access to health care, emergency triage, and lack of early recognition [9][10][11]. Mortality for adults with sepsis [5,12,13] and acute respiratory distress syndrome (ARDS) [14][15][16] in resource-limited settings is higher than in resource-rich settings, and decedents are usually young (mean age 35 years vs. 61 years in United States) [12,17], which contributes to a greater negative downstream social and economic impact.…”